NSG 554 Exam 4 | Questions with Verified Answers.
1. Gynecomastia -Aging
causes -Neonatal period, puberty (tall/overweight teenagers)
-Obesity
2. Hypothyroidism -85% women
-May be due to failure or resection of the thyroid gland itself
or deficiency of pituitary TSH
3. Goiter -May be present with thyroiditis, iodine deficiency, genet-
ic thyroid enzyme defects, drug goitrogens (lithium, io-
dine, propylthiouracil or methimazole, sulfonamides, amio-
darone, interferon-alpha, interferon-beta, interluekin-2,
food goitrogens in iodine-deficient areas
* often absent in autoimmune thyroiditis
4. Hypothyroidism Serum TSH - high in primary and low in secondary hy-
labs pothyroidism
Elevated in Hashimoto thyoiditis
5. Hyperthyroidism Serum TSH= suppressed except in TSH-secreting pitu-
labs itary tumor or pituitary hyperplasia (rare)
T3 uptake and scan= elevated, increased uptake
6. Subclinical hy- Normal T4 with increased TSH
pothyroidism may or may not have symptoms
7. Hypothyroid -Synthetic levothyroxine
Treatment -Average does 1.6mcg/kg/day
-Repeat TSH in 4-6 week after initiation
-TSH levels should be between 0.4-2
8. Hyperthyroidism -Clinical manifestations of elevated T4 or T3
(Thyrotoxicosis) -Most common form is Graves Disease
9. Grave's Disease -Most common cause of thyrotoxicosis
-Autoimmune disorder affecting the thyroid gland
-Increase in the synthesis & release of thyroid hormones
-More common in women
-Onset age 20-40
, NSG 554 Exam 4 | Questions with Verified Answers.
-Dietary iodine supplementation, chemotherapy can trig-
ger
-Increased r/f systemic autoimmune dx including Sjogren,
celiac, pernicious anemia, Addison's, alopecia aerate, vi-
tiligo, DM1, hypoparathyriodism, myasthenia gravis, car-
diomyopathy
10. Hyperthyroid ex- -Diffusely enlarged thyroid
amination find- -Frequent asymmetric and often with bruit
ings
-Subacute: moderately enlarged/tender, dysphagia,
jaw/ear pain
-toxic multi nodular goiter: palpable nodules
-Silent thyroiditis: small nontender goiter
11. PALM-COEIN -Polyp, adenomyosis, leiomyoma, malignancy and hyper-
plasia
-Coagulopathy, ovulatory dysfunction, endometrial, iatro-
genic, Not yet classified
12. Abnormal pre- -CBC, pregnancy test, thyroid tests.
menstrual bleed- -Vaginal and urine samples for PCR or culture to r/o
ing: Laboratory chlamydia
studies
13. Vaginitis -inflammation and infection of the vagina
-caused by a variety of pathogens, allergic reactions to
contraceptives or other products, vaginal atrophy, friction
during coitus
-normal pH is 4.5 or less
14. Vaginitis: Clinical -vaginal irritation, pain, unusual or malodorous discharge
findings -Hx including LMP, recent sexual activity, use of contra-
ceptives, tampons, douches, recent changes in meds or
use of abx, presence of burning, pain, pruritus, profuse
discharge
15. Vaginitis: PE -inspection of vulva
-speculum exam of vagina, cervix
-vaginal/cervical/urine sample for detection of chlamydia
